Role of Micronutrients in Perioperative Care: A Systematic Review.
Level 2 - randomized trial
Systematic review combining both randomized controlled trials and observational studies with narrative synthesis
PubMed 42146980 · doi:10.5005/jp-journals-10071-25153
What was done
A PRISMA-guided systematic review of major databases and trial registries through August 2025 assessed micronutrient status or supplementation (iron, vitamin C, vitamin D, selenium, zinc) on surgical outcomes. Eligible designs included randomized controlled trials and observational studies reporting on wound healing, surgical-site infections, transfusion requirements, organ dysfunction, pain, and hospital length of stay. Risk of bias was evaluated with standard tools, and findings were synthesized narratively due to heterogeneity.
What was found
Twenty-two studies were included. The abstract provides no quantitative effect sizes or numerical data, reporting qualitatively that: intravenous iron consistently elevated hemoglobin and iron stores but had variable effects on transfusion rates; vitamin C supplementation reduced perioperative pain and modestly improved wound healing; selenium normalization showed no clinical benefit; and low vitamin D and zinc levels correlated with higher infection rates and delayed healing, though interventional trial evidence was limited.
Why it matters
This review argues against routine empiric high-dose micronutrient supplementation, instead supporting targeted screening and correction of documented deficiencies in high-risk surgical patients.
Limits
The review relies on narrative synthesis rather than meta-analysis due to substantial heterogeneity across eligible study designs (mixing RCTs and observational studies) and outcome measures. Abstract provides no numerical data, confidence intervals, or sample sizes for individual studies, and interventional evidence remains sparse for several nutrients including vitamin D and zinc.
Cited by
- contradicts Taking 50,000 IUs of vitamin D3 with magnesium and K2 for 3 days before any surgical procedure greatly improves outcomes.